Background: To assess the value of intra-tumoral (endometrial) flow as detected by color Doppler ultrasound in relationship with negative prognostic factors in patients with endometrial carcinoma.
Methods: Fifty-three patients with a previous histological diagnosis of endometrial carcinoma were included in the study. Transvaginal ultrasound with pulsed color Doppler was performed in order to record resistance indexes and vascular density (defined as "high" if > or = 3 vascular spaces were detectable for any given area). All cases were classified according to FIGO after surgery and histology. Prognostic bad factors were considered: FIGO stage (> I), tumor grade (> 1), myometrial invasion (> 50%) involvement of vascular spaces and lymph node metastasis.
Results: Both resistance indexes and vascular density in the endometrium related well to more prognostic signs. No relationship was found for lymph node metastasis, probably justified by the small number of positive nodes (2/27).
Discussion: Color Doppler ultrasound seems to be a promising technique in pre-surgical staging of endometrial carcinoma. Detection of vascular spaces rather than low resistance indexes is, in personal experience, more significantly related to advanced disease. It is hypothesized that long term follow-up of these patients can show a predictive value of Doppler ultrasound on the outcome of the disease.